The May 10 issue of the Journal of the American College of Cardiology features a study that casts doubt on BMI, or body mass index, a common gauge of wellness used by many in the wellness field, from physicians to personal trainers.

At Cenegenics, we’ve always assessed our patients based on multiple factors and BMI isn’t one of them. The reason we have not relied on BMI as a health assessment is backed up by the recent study: People who have fat distributed evenly throughout their body do not have as high a risk of heart disease as those with “central obesity,” or belly fat. For the study, researchers at the Mayo Clinic analyzed data from almost 16,000 coronary artery disease patients around the world and found that the death rate was two times higher for patients who packed extra weight in their midsections than for their counterparts who carry their weight elsewhere in the body.

Which means? A patient carrying extra weight in the midsection can have an increased risk of heart disease, even if their BMI falls in the healthy range. BMI is simply a measure of weight in proportion to height and does not take factors such as fat distribution in the body into account. Belly fat is a strong indicator of many risk factors—not just for heart disease, but also for diabetes, high blood pressure, high triglycerides, and what we call “metabolic syndrome” in general.

It’s also important to understand the difference between subcutaneous and visceral fat. Subcutaneous fat lies just under the surface of the skin, while visceral fat is packed between organs (stomach, liver, kidneys, intestines, etc.) in the midsection of the body, making it much more dangerous than typically evenly distributed subcutaneous fat found throughout the entire body. Excess visceral fat is linked to diabetes, insulin resistance, inflammatory diseases, and other obesity-related conditions, so individual assessments of fat distribution are imperative—as is an individualized treatment plan. Hormonal changes can cause an increase in belly fat and men are more likely than women to store fat in the midsection, so testing for hormone levels is a key part of our assessments.

Additionally, every patient is unique, which is why the simple BMI measurement is not a good starting place for making decisions for nutritional changes, hormone supplementation, and a fitness program. In the JACC study, patients with a healthy BMI were at heightened risk for disease when their waist measurement exceeded 33 inches (men) and 31 inches (women). In our age management practice, we ensure each patient’s assessment includes multiple factors, and distribution of body weight and ratio of muscle of fat in the body is just one part of it. To quote Dr. Jeffry Life, Cenegenics senior institute physician and author of The Life Plan, “being overweight is not the problem. Being overfat is.”

Speaking of Dr. Life, we are excited to announce that he is now seeing patients at the Cenegenics Carolinas office in Charleston, S.C.! Contact us for more details or to schedule an appointment at (843) 577-8484.